Joint Entrance Examination (Advanced) 2022

Indian Institutes of Technology

REGISTRATION RECEIPT

Registration No. B51121048095

Candidate Details
JEE (Main) Application 220310133462 Date of Birth 25/02/2004
number
Candidate's Name SARTHAK DEBATA Category GENERAL
Mother's Name RAJASHREE DEBATA Person with Disability (PwD) As per No
JEE(Main)
Father's Name SUKUMARA DEBATA Nationality INDIAN
Complete Mailing Address
Address ETHICS ASHIYANA,GROUND FLOOR
Country India
State ODISHA District KHORDHA
Locality Mobile Number 91-832****174
City/Town/Village RAJIV NAGAR,PATIA STATION ROAD,BHUBANESWAR Email Address deb**********@gmail.com
Pin Code / Postal Code 751024 Additional Mobile number --
Land Line Number -- Additional Email Address --
Academic details of Class XII (or equivalent) examination
Year of Passing or Appearing 2022
Name of the Class XII (or equivalent) examination THE FINAL EXAMINATION OF THE 10+2 SYSTEM, CONDUCTED BY ANY RECOGNIZED CENTRAL/ STATE
BOARD, SUCH AS CENTRAL BOARD OF SECONDARY EDUCATION, NEW DELHI; COUNCIL FOR THE INDIAN
SCHOOL CERTIFICATE EXAMINATIONS, NEW DELHI; ETC.
School Board CENTRAL BOARD OF SECONDARY EDUCATION
Roll Number 12643985
Name of the School / College CENTRAL BOARD OF SECONDARY EDUCATION
Address of the School / College DOON INTERNATIONAL SCHOOL,PLOT-109,ADJACENT TO AIIMS,BHUBANESWAR,ODISHA
JEE (Main) Paper 1 Score
Physics: 95.0797000 Chemistry: 87.8508484 Maths: 41.5113743 Total: 91.5654533
Remarks : Eligible for JEE (Advanced) 2022.
Furnished Information for JEE (Advanced)
Need scribe/reader NOT APPLICABLE Do you want to avail compensatory time NOT APPLICABLE
as of GoI guidelines/ memorandum?
Class XIIth (or equivalent)/ Qualifying India Year of first appearance in Class XII 2022
Exam (QE) Passed From Exam
Year of first attempt in JEE (Advanced) 2022 Color Blindness No
One Eyed Vision No Eligible for DS Seats NO
Examination City for JEE (Advanced)
1st Choice of Exam City ODISHA-BHUBANESWAR 2nd Choice of Exam City ODISHA-CUTTACK (CUTTACK-
DHENKANAL)
3rd Choice of Exam City ODISHA-ROURKELA 4th Choice of Exam City ODISHA-SAMBALPUR (SAMBALPUR-
BARGARH)
5th Choice of Exam City ODISHA-BERHAMPUR (GANJAM) 6th Choice of Exam City ODISHA-BALASORE (BALASORE-
BARIPADA-BHADRAK)
7th Choice of Exam City WEST BENGAL-KOLKATA (NORTH) 8th Choice of Exam City WEST BENGAL-KOLKATA (SOUTH)
(HOWRAH)
Payment Details
Payment Mode SBI MOPS Transaction ID 1867261919
Registration Fee 2800 ( INR ) Date of Transaction 09/08/2022 13:40:23
DECLARATION
I hereby declare that all the particulars stated in this Registration Receipt are true to the best of my knowledge and belief. I have read and understood the JEE (Advanced)
procedures. I shall abide by the terms and conditions therein. I understand that, if any of the information provided by me is found to be false / incorrect at any later time, my
candidature shall be cancelled and I shall be debarred from appearing for JEE (Advanced). This my first/second attempt in JEE (Advanced). In case, it is found that I am ineligible
to appear for JEE (Advanced) 2022 at any stage, I agree that my candidature will be cancelled and registration fee will be forfeited.
Images Uploaded by Candidate (During JEE (Main) Registration)
Certificates uploaded
Class-X or Birth Certificate Uploaded Class-XII (or equivalent) Mark Sheet Uploaded
Category Certificate Not Applicable Additional GENERAL Certificate Not Applicable
PwD Certificate Not Applicable Scribe Request Letter Not Applicable
DS Certificate Not Applicable PIO Card / OCI Card Not Applicable
Compensatory Time Request Not Applicable Gazette notification showing the change of Not Applicable
Letter name